Three-dimensional evaluation of lingual split line after bilateral sagittal split osteotomy in asymmetric prognathism
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: The aim of this study was to evaluate the pattern of lingual split line when performing a bilateral sagittal split osteotomy (BSSO) for asymmetric prognathism. This was accomplished with the use of cone-beam computed tomography (CBCT) and three-dimensional (3D) software program. Materials and Methods: The study group was comprised of 40 patients (20 males and 20 females) with asymmetric prognathism, who underwent BSSO (80 splits; n=80) from January 2012 through June 2013. We observed the pattern of lingual split line using CBCT data and image analysis program. The deviated side was compared to the contralateral side in each patient. To analyze the contributing factors to the split pattern, we observed the position of the lateral cortical bone cut end and measured the thickness of the ramus that surrounds the mandibular lingula. Results: The lingual split patterns were classified into five types. The true “Hunsuck” line was 60.00% (n=48), and the bad split was 7.50% (n=6). Ramal thickness surrounding the lingual was 5.55±1.07 mm (deviated) and 5.66±1.34 mm (contralateral) (P=0.409). The position of the lateral cortical bone cut end was classified into three types: A, lingual; B, inferior; C, buccal. Type A comprised 66.25% (n=53), Type B comprised 22.50% (n=18), and Type C comprised 11.25% (n=9). Conclusion: In asymmetric prognathism patients, there were no differences in the ramal thickness between the deviated side and the contralateral side. Furthermore, no differences were found in the lingual split pattern. The lingual split pattern correlated with the position of the lateral cortical bone cut end. In addition, the 3D-CT reformation was a useful tool for evaluating the surgical results of BSSO of the mandible.
Abstract
Objectives: The aim of this study was to evaluate the pattern of lingual split line when performing a bilateral sagittal split osteotomy (BSSO) for asymmetric prognathism. This was accomplished with the use of cone-beam computed tomography (CBCT) and three-dimensional (3D) software program. Materials and Methods: The study group was comprised of 40 patients (20 males and 20 females) with asymmetric prognathism, who underwent BSSO (80 splits; n=80) from January 2012 through June 2013. We observed the pattern of lingual split line using CBCT data and image analysis program. The deviated side was compared to the contralateral side in each patient. To analyze the contributing factors to the split pattern, we observed the position of the lateral cortical bone cut end and measured the thickness of the ramus that surrounds the mandibular lingula. Results: The lingual split patterns were classified into five types. The true “Hunsuck” line was 60.00% (n=48), and the bad split was 7.50% (n=6). Ramal thickness surrounding the lingual was 5.55±1.07 mm (deviated) and 5.66±1.34 mm (contralateral) (P=0.409). The position of the lateral cortical bone cut end was classified into three types: A, lingual; B, inferior; C, buccal. Type A comprised 66.25% (n=53), Type B comprised 22.50% (n=18), and Type C comprised 11.25% (n=9). Conclusion: In asymmetric prognathism patients, there were no differences in the ramal thickness between the deviated side and the contralateral side. Furthermore, no differences were found in the lingual split pattern. The lingual split pattern correlated with the position of the lateral cortical bone cut end. In addition, the 3D-CT reformation was a useful tool for evaluating the surgical results of BSSO of the mandible.
참고문헌 (23)
- Trauner R, "The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. I. Surgical procedures to correct mandibular prognathism and reshaping of the chin", Oral Surg Oral Med Oral Pathol, 10, pp.677~689 (1957)
- Dal Pont G, "Retromolar osteotomy for the correction of prognathism", J Oral Surg Anesth Hosp Dent Serv, 19, pp.42~47 (1961)
- Hunsuck EE, "A modified intraoral sagittal splitting technic for correction of mandibular prognathism", J Oral Surg, 26, pp.250~253 (1968)
- Plooij JM, "3D evaluation of the lingual fracture line after a bilateral sagittal split osteotomy of the mandible", Int J Oral Maxillofac Surg, 38, pp.1244~1249 (2009)
- Muto T, "Evaluation of the mandibular ramus fracture line after sagittal split ramus osteotomy using 3-dimensional computed tomography", J Oral Maxillofac Surg, 70, pp.e648~e652 (2012)
- Baek SH, "Skeletodental factors affecting chin point deviation in female patients with class III malocclusion and facial asymmetry: a three-dimensional analysis using computed tomography", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 104, pp.628~639 (2007)
- You KH, "Three-dimensional computed tomography analysis of mandibular morphology in patients with facial asymmetry and mandibular prognathism", Am J Orthod Dentofacial Orthop, 138, pp.540.e1~540.e8 (2010)
- Klinge B, "Location of the mandibular canal: comparison of macroscopic findings, conventional radiography, and computed tomography", Int J Oral Maxillofac Implants, 4, pp.327~332 (1989)
- Kondo T, "Computer-based extraction of the inferior alveolar nerve canal in 3-D space", Comput Methods Programs Biomed, 76, pp.181~191 (2004)
- Yang WS, "The study on the orthodontic patients who visited department of orthodontics, Seoul National University Hospital during 10 years (1985-1994)", Korean J Orthod, 25, pp.497~509 (1995)
- 윤규식, "하악골 전돌증을 동반한 안모비대칭의 유형 분석", 대한구강악안면외과학회지, 30(2), pp.108~120 (2004), 대한구강악안면외과학회
- Kwon TG, "A comparison of craniofacial morphology in patients with and without facial asymmetry--a three-dimensional analysis with computed tomography", Int J Oral Maxillofac Surg, 35, pp.43~48 (2006)
- Kwon TG, "Relationship between the masticatory muscles and mandibular skeleton in mandibular prognathism with and without asymmetry", J Oral Maxillofac Surg, 65, pp.1538~1543 (2007)
- Yamamoto R, "Relationship of the mandibular canal to the lateral cortex of the mandibular ramus as a factor in the development of neurosensory disturbance after bilateral sagittal split osteotomy", J Oral Maxillofac Surg, 60, pp.490~495 (2002)
- 이재열, "안면 비대칭환자의 하악골체부의 시상 단면에 관한 연구", 대한구강악안면외과학회지, 37(2), pp.109~113 (2011), 대한구강악안면외과학회
- Wolford LM, "The mandibular inferior border split: a modification in the sagittal split osteotomy", J Oral Maxillofac Surg, 48, pp.92~94 (1990)
- MacIntosh RB, "Experience with the sagittal osteotomy of the mandibular ramus: a 13-year review", J Maxillofac Surg, 9, pp.151~165 (1981)
- Turvey TA, "Intraoperative complications of sagittal osteotomy of the mandibular ramus: incidence and management", J Oral Maxillofac Surg, 43, pp.504~509 (1985)
- Panula K, "Incidence of complications and problems related to orthognathic surgery: a review of 655 patients", J Oral Maxillofac Surg, 59, pp.1128~1136 (2001)
- Guernsey LH, "Sequelae and complications of the intraoral sagittal osteotomy in the mandibular rami", Oral Surg Oral Med Oral Pathol, 32, pp.176~192 (1971)
- Veras RB, "Functional and radiographic long-term results after bad split in orthognathic surgery", Int J Oral Maxillofac Surg, 37, pp.606~611 (2008)
- Akhtar S, "Unfavorable splits in sagittal split osteotomy", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 87, pp.267~268 (1999)
- Chrcanovic BR, "Risk factors and prevention of bad splits during sagittal split osteotomy", Oral Maxillofac Surg, 16, pp.19~27 (2012)